AB0621 DISEASE ACTIVITY PATTERNS OVER TIME IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: IMPACT ON HEALTH-RELATED QUALITY OF LIFE
Authors: L. Gualtieri, E. Elefante, D. Schilirò, C. Stagnaro, V. Signorini, D. Zucchi, C. Cardelli, F. Trentin, G. Cascarano, A. Valevich, L. Carli, F. Ferro, C. Tani, M. Mosca
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Health-Related Quality of Life (HRQoL) in patients with autoimmune systemic diseases has a multifactorial origin. In particular, data from the literature show that in patients with Systemic Lupus Erythematosus (SLE) the correlation between HRQoL and disease manifestations is quite controversial. <h3>Objectives</h3> to evaluate the impact of different disease activity patterns on HRQoL and patients' perception of disease activity in a monocentric cohort of patients with SLE. <h3>Methods</h3> a retrospective analysis of prospectively collected data from adult consecutive patients with a diagnosis of SLE, regularly followed at the Rheumatology Unit of Pisa. For each patient, the following data were collected: demographics, disease duration, clinical and laboratory data, SELENA-SLEDAI for disease activity and SLICC-DI for organ damage, comorbidities and ongoing treatment. Three different disease patterns were defined based on disease activity status during the year before enrollment: long quiescent (LQ) if patients were in remission in each visit; chronically active (CA) if they were not in remission in each visit; relapsing-remitting (RR) if patients presented periods of remission interspersed with periods of disease activity. Only patients with at least two visits in the year before enrollment were included. We excluded patients with a major clinical event/hospitalization not SLE-related during the year before enrolment that could influence their health status. At enrollment, each patient completed the following Patient Reported Outcomes (PROs): SF-36, FACIT-F, Lupus Impact Tracker (LIT), SLAQ, Hospital Anxiety and Depression Scale (HADS). <h3>Results</h3> 242 SLE outpatients were enrolled, mainly female (91.7%) and of Caucasian ethnicity (96.7%); mean age 44.2.6 ± 13 years, with a median disease duration of 12 years (IQR 6 – 21). 48.8% had at least one item of organ damage with a median SLICC-DI of 1 (IQR 1-2). Moreover, 15.3% of patients had a concomitant fibromyalgia. At enrollment, median SLEDAI in the entire cohort was 2 (IQR 0-4); the most frequent active disease manifestation was skin involvement (36/242); 12 patients had active arthritis and 11 active renal disease. Almost half of the cohort (51,2%) was on a low dose of glucocorticoids (mean daily dose 4.1 ± 2.9 mg of 6-methylprednisolone); 83.9% were on Hydroxychloroquine and 52.5% on immunosuppressive therapy. We applied the disease pattern definition criteria and we found that the LQ was the most represented pattern in our cohort (63.9% of patients), followed by the RR (22%) and CA (14.1%). No significant differences in SF-36, HADS, LIT and FACIT results were observed between the 3 groups. Only SLAQ scores resulted significantly higher in the RR group compared with the LQ one (p&lt;0.01) (Table 1). <h3>Conclusion</h3> our study shows that HRQoL in SLE is not significantly influenced by disease course over time, confirming that disease activity does not represent the major determinant of patients' perception of health status. However, we found that patients' self-evaluation of disease activity is affected by the disease pattern over time. Particularly, it seems that alternating periods of disease activity to periods of remission over time may worsen the patient's evaluation of disease status, even more than a mild chronically active disease. <h3>Reference</h3> [1]Györi N et al., Lupus Sci Med. 2017 Feb 8;4(1):e000192. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.